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【はじめに】硫化亜鉛 (ZnS)は禁制帯幅が約 3.7eVと大きく、酸化亜鉛 (ZnO)と同様、透明な半導 体である。p/n型の導電性制御について既報であり、その格子定数は SiやGaPと近いこともあり、 酸化亜鉛 (ZnO)との異種接合構造によるデバイス作製に期待がもてる材料である。 ミストCVD法は、溶液原料を超音波でドライミスト化して結晶成長する手法である [1]が、我々 はこれまで、VI族源にチオ尿素を用いることで、ZnSの成膜が可能であることを示してきた。[2-3] ミストCVD法による ZnS成長では、原料に酢酸亜鉛や硫酸亜鉛を用いた時には成膜できず、塩化 亜鉛を用いた時に成膜が可能であることが分かっている。今回我々は、原料溶液中の塩素イオン の濃度と ZnSの成膜量を調べることで、ミスト CVD法における ZnS成長の化学的な反応機構に ついて実験的考察を行ったので報告する。一方、ミスト CVD法の物理的な成長機構を検討するた めに、II族源と VI族源を個別供給してミスト CVD成長した実験結果についても報告する。

Growth of zinc oxide (ZnO) on pyrolytic graphite sheet (PGS) by electrochemical deposition (ECD) and mist chemical vapor deposition (CVD) was investigated in the viewpoint of crystal orientations. We examined the fullwidth at half-maximum (FWHM) of X-ray rocking curve profiles of graphite 0002 and ZnO 0002 diffractions for the investigations. In the case of ECD, thermal annealing at 400, 800, and 1000 °C for PGS before the growth reduced the FWHM value of the grown ZnO. On the other hand, in the case of mist CVD, the growth process and an etching process which may flatten the surface roughness simultaneously occurred. As a result, the FWHM values of the grown ZnO and the PGS were almost the same. These results indicate that each ZnO grain was grown on each graphite grain along with a same c-orientation direction. (© 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

Temperature dependence of photoluminescence properties of zinc sulfide (ZnS) films, which were successfully grown from aqueous solutions by using mist chemical vapor deposition method, was investigated. The samples were grown at 500–700°C. Although the excitation condition using 325nm HeCd laser was below-gap excitations under 80 K, strong photoluminescence (PL) emissions were observed around 450nm. Because the PL peak strength increases with increasing the growth temperature, the origin of the 450nm peak would be sulfur vacancies. The peaks have small thermal quenching properties. The ZnS film grown at 500°C has a weaker luminescence from the sulfur vacancies than the other films. Additionally, the sample shows peaks around 360nm which would be originated from zinc oxide.

Background The neurological prognosis is poor for patients suffering from out-of-hospital cardiac arrest (OHCA), in the absence of bystander cardio pulmonary resuscitation (CPR), and showing asystole as the initial waveform. However, such patients have the potential of resuming social activity if cerebral tissue oxygen saturation can be preserved. Case presentation We recently encountered a 60-year-old man who had suffered an OHCA in the absence of bystander CPR, and who successfully resumed complete social activity despite initial asystole and requiring at least 75 min of chest compressions before return of spontaneous circulation (ROSC). In this case, chest compression was appropriately performed concurrently with real-time evaluation of cerebral tissue oxygenation using near-infrared spectroscopy (NIRS). As a result, the cerebral tissue oxygenation was well maintained, leading to resumption of social activity. Conclusions Improved neurological prognoses can be expected if OHCA patients with the potential for social activity resumption are identified, using NIRS, and effective cardiopulmonary and cerebral resuscitation is performed while visually checking CPR quality.

We investigated the allelic distributions of single nucleotide polymorphisms (SNPs) of the TNFA, TNFB and IKBL genes, 3 microsatellites within the tumor necrosis factor (TNF) region of HLA locus, and the HLA phenotypes as well as the TLR4 gene in Chromosome 9 in 26 healthy Caucasian volunteers. These individuals were also assessed as ultraviolet B (UVB)-susceptible (S) or UVB-resistant (R). Our results identified 12 UVB-S and 14 UVB-R individuals. Attempts to correlate particular HLA-A, -B, -C, and -DR antigens with the UVB phenotypes failed. Similarly, attempts to correlate SNP at the NcoI-RFLP within intron 1 of the TNFB, IKBL and TLR4 gene with UVB phenotypes also failed. However, microsatellite analyses of TNFa, TNFc, and TNFd markers revealed a significant increase in the frequencies of TNFa2 in UVB-S individuals (P=0.00032) and of TNFd3 in UVB-R individuals (P=0.012). Moreover, DNA sequencing analyses of 5 SNPs of the TNFA promoter region revealed a significant increase in the frequency of the allele B of the TNFA gene (TNFApB) representing the nucleotide A at position -863 and C at position -1031 (P=0.015). Since it is known that TNFa2 and TNFApB is a high TNF-alpha responder, whereas TNFd3 is a TNF-alpha low responder, we propose that the TNF region of HLA contains polymorphic genes that confer susceptibility and resistance to the deleterious effects of UVB radiation on the induction of contact hypersensitivity. This proposal is consistent with previous reports that a unique microsatellite region of the Tnfa gene in mice contains alleles that dictate the UVB-dependent phenotypes in mice, and implicate TNF-alpha as the primary mediator of the immune-damaging effects of UVB radiation.

UNLABELLED There is no report concerning oral clonidine's effects on epidural lidocaine in children. Therefore, we performed a study to assess the concentrations of plasma lidocaine and its major metabolite (monoethylglycinexylidide [MEGX]) in children receiving continuous thoracic epidural anesthesia after oral clonidine premedication. Ten pediatric patients, aged 1-9 yr, were randomly allocated to the Control or Clonidine 4 microg/kg group (n = 5 each). Anesthesia was induced and maintained with sevoflurane in oxygen and air (FIO2 40%). Epidural puncture and tubing were carefully performed at the Th11-12 intervertebral space. An initial dose of 1% lidocaine (5 mg/kg) was injected through a catheter into the epidural space, followed by 2.5 mg x kg(-1) x h(-1). Plasma concentrations of lidocaine and MEGX were measured at 15 min, 30 min, and every 60 min for 4 h after the initiation of continuous epidural injection. The concentrations of lidocaine and MEGX were measured using high-pressure liquid chromatography with ultraviolet detection. Hemodynamic variables were similar between members of the Control and Clonidine groups during anesthesia. The Clonidine group showed significantly smaller lidocaine concentrations (p < 0.05) and the concentration of MEGX tended to be smaller in the plasma of the Clonidine group for the initial 4 h after the initiation of epidural infusion. In conclusion, oral clonidine preanesthetic medication at a dose of 4 microg/kg decreases plasma lidocaine concentration in children. IMPLICATIONS Oral clonidine decreases the plasma lidocaine concentration in children. Our finding may have clinical implications in patients receiving continuous epidural anesthesia. Additionally, perhaps an additional margin of safety regarding lidocaine toxicity is gained through the use of oral clonidine in children who will receive epidural lidocaine.

Polymorphisms of the 5′-flanking promoter/enhancer region of the TNFA gene were determined in 80 Japanese patients with pulmoplantar pustulosis (PPP). The 5′-flanking region of the TNFA gene from –1107 to –66 was amplified by polymerase chain reaction (PCR) method. Nucleotide sequencing data from the PCR products revealed that 5 single nucleotide polymorphisms at position –1031, –863, –857, –307 and –237. None of the nucleotide substitutions were significantly increased in PPP patients when compared with those in controls. To clarify the linkage among the neighboring genetic marker, we analyzed the association between the polymorphisms in the TNFA promoter region and the NcoI polymorphism in the first intron of the TNFB gene as well as HLA-DR9. The genotype at –1031C is strongly associated with TNFB1 and negatively associated with TNFB2 which is reported to be associated with PPP. These data indicate that TNFA gene centromeric to TNFB is not associated with PPP and the susceptible gene of PPP is located between TNFB and HLA-B.

低体重の末期腎不全児に対する血液透析を困難にしている最大の原因は, ブラッドアクセスの問題である. 我々は, ブラッドアクセスとして, ダクロンカフ付シリコン性カテーテルであるHickman catheter® (Bard, Utah, USA) を使用し, 以下の知見を得た.対象は, カテーテル挿入時年齢15か月から84か月, 体重7.8kgから13.8kgの小児. 血液透析の適応理由は, 腹膜炎の反復, 生体肝移植後, 膀胱拡大術後, 嚢胞腎による低腹腔容積であった. カテーテル留置に伴う合併症としては, 70か月間血液透析を継続した例の敗血症一度のみであった. また, 生体肝移植後の女児は5時間の血液濾過透析, 他の3例は通常の4時間透析を行い, 透析効率はKt/Vで1.06から1.41であった. 管腔内の血栓形成の予防は, 毎日のheparin sodium注入と一例にのみaspirin少量投与により可能であった.今後, 腎不全小児の病態の多様化により腹膜透析の困難な症例が増加してくると思われるが, Hickman catheter®を使用することにより血液透析も容易に施行できるものと思われる.

We report a patient with the typical lesions of diabetic scleredema. Histological findings of the involved skin were thickening of the dermis, depositions of mucins, and fibrosis. Biochemical analysis revealed an increase in glycosaminoglycans in the involved skin as well as in the cutaneous lupus mucinosis. Mucinous materials were composed of hyaluronic acid.

The growth mechanisms of zinc oxide and zinc sulfide films by mist chemical vapor deposition (mist-CVD) were experimentally investigated from the viewpoint of mist behaviors and chemical reactions. The proper growth model, either vaporization or the Leidenfrost model, was studied by supplying two kinds of mists with different kinds of sources, such as H2 16O and H2 18O for ZnO growth and ZnCl2 and thiourea for ZnS growth. Moreover, the origin of the oxygen atoms of ZnO was investigated using a quantitative analysis. The role of chloro complex of zinc in the growth of ZnS from aqueous solutions was also examined by systematic studies.

While lichen amyloidosus reportedly may respond to dimethyl sulfoxide (DMSO) application, we present a patient whose lesions were refractory to this agent. This Japanese woman had chronic extensive lichen amyloidosus, mainly on her trunk. Her 10-year history of using nylon towels was the suspected cause. The application of DMSO ointment had no clinical effect, and the amyloid deposits persisted in the histological specimens despite the treatment. The administration of a topical corticosteroid led to gradual clinical improvement.

We investigated the allele and genotype distribution of a polymorphism of the tumor necrosis factor (TNF) B gene and the frequency of HLA-DR9 in 49 patients with Palmoplantar pustulosis (PPP) and 51 healthy controls. We found that the frequency of TNFB2 in the PPP patients was significantly higher than that in the controls. Furthermore, the DR9-TNFB2 haplotype was significantly more frequent in the PPP patients (P=0.0045). These results suggest that TNFB2 may confer susceptibility to PPP.

Tetanus is an infectious disease caused by Clostridium tetani, which manifests systemic convulsion and autonomic instability associated with high case fatality. Despite proper medical intervention, management of those symptoms is often difficult. We report a case of 67-year-old man with tetanus in which a concomitant use of dexmedetomidine, an adrenaline alpha-2 receptor agonist, and propofol, a GABA(A) receptor binding agent, was successful in the management of systemic convulsion and autonomic instability without necessitating conventional anticonvulsant, neuromuscular blocking agents, or tracheostomy.

Acute idiopathic pandysautonomia (AIPD) is a very rare disease with acute onset of impairment in the peripheral sympathetic and parasympathetic nerves. We report the anesthetic management of a patient with AIPD undergoing bladder lithotomy and scrotum abscess drainage. A 64-year-old man had a severe orthostatic hypotension, and was extremely sensitive to intravenous norepinephrine because of denervation hypersensitivity. Before the surgery, the patient was sufficiently hydrated. We planned to administer a vasopressor (phenylephrine) and a vasodilator (nicardipine) at 1/10 of usual doses. After placement of a radial artery catheter, combined epidural and spinal anesthesia was performed with the patient in a right lateral position. Blood pressure decreased slightly after placing him in a supine position. However, no medication was needed, and the patient showed no perioperative complications.

A sensitive and specific radioimmunoassay system for rat plasma cholecystokinin (CCK) was employed to study the effect of trypsin inhibitor on plasma CCK levels. Feeding the trypsin inhibitor, FOY-305 200 mg/kg, to rats for 10 days stimulated the pancreatic growth. However, there was no significant difference in fasting plasma concentrations and duodenal contents of CCK and secretin. On the other hand, acute ingestion of same dosage of FOY-305 caused a marked (20-fold) and sustained elevation of plasma CCK levels. The principal form of circulating CCK was CCK-22 like on Sephadex G-50, in contrast to that of the cerebrum and duodenum where CCK-8 like form, or CCK-8 and CCK-22 like forms were main components, respectively. A significant rise in plasma levels of immunoreactive secretin was also found. These results suggest that the pancreatic growth observed by feeding the trypsin inhibitor to rats is caused by an excessive amount of CCK in conjunction with secretin.

Prurigo pigmentosa is an inflammatory dermatosis characterized by pruritic, reddish, papular lesions and gross reticular pigmentation that occurs mainly on the trunk. Nearly 100 cases have been reported in Japan to date. We describe a patient with this condition who responded well to dapsone. An electron microscopic study of the reddish papular lesion showed marked intercellular edema and evidence of cellular injury of the basal cells. Direct immunofluorescence was negative. We stress that this condition is a distinct clinical entity, histologically characterized by a lichenoid tissue reaction as proposed by Pinkus, although it is little known outside Japan.

Molecular forms of cholecystokinin ( CCK ) in the peripheral circulation were studied in normal subjects and cirrhotic patients. Fractionation of plasma extract collected 20 min after intraduodenal infusion of fat revealed four major peaks by Sephadex G-50 column chromatography in normal subjects. Peak I eluted at a position similar to CCK-33, peaks II and III eluted between CCK-33 and CCK-14, and peak IV eluted between CCK-14 and CCK-8. In cirrhotic patients, there was a prominent peak ( peak V ) eluted at a position similar to CCK-8, in addition to those four peaks. These findings are consistent with the previous observations of hepatic elimination of CCK-8, and suggest that smaller forms of CCK similar in size to CCK-8 are not major forms of CCK in plasma in normal subjects but circulate substantially in cirrhotic patients.

Three cases of fibrous papule of the nose (FPN) were studied by electron microscopy. All three showed similar ultrastructural features; in the overlying epidermis, a number of large and small vacuoles without limiting membranes were observed within the keratinocytes, and melanocytes and melanosome-complexes in the keratinocytes were increased in number; in the dermis, a number of mono- and binuclear mesenchymal cells which may well be regarded as fibrohistiocytic cells, proliferation and dilation of capillaries and venules, and a considerable number of Zebra bodies were seen. Neither melanocytes nor nevus cells were found in the dermis. These findings suggest that the large pale cells seen in the epidermis by light microscopy are vacuolated keratinocytes and that FPN has characteristics not of a nevocellular nevus but of an angiofibromatous tumor similar to so-called adenoma sebaceum of Pringle's disease.

Pyruvate and lactate in duodenal aspirates were investigated to determine whether they are excreted from human pancreas as substrates for alkaline secretion as is bicarbonate. Secretion of these acids was compared with that of another organic acid, citrate, which is thought to be excreted in close relationship to digestive enzymes. All acids were assayed in the fluid obtained from 11 subjects without pancreatic diseases, before and after sequential intravenous injections of 1 unit/kg pancreozymin and 1 unit/kg secretin. Pyruvate concentrations were markedly increased by each stimulation, especially by secretin, and the cumulative excretions of pyruvate and bicarbonate after secretin stimulation were significantly correlated among the subjects. In contrast, lactate concentrations, although high just after administration of pancreozymin, declined to a considerable extent following each injection, rather similar to those of protein or citrate. These data suggest that pyruvate may be secreted from human pancreatic duct cells similar to bicarbonate secretion through mechanisms related to alkaline secretion.

We report a patient with vesicular pemphigoid who showed clinically numerous small vesicles and figurate erythema over the trunk and extremities. Although large blisters were absent, immunofluorescent study revealed IgG and C3 deposition at the basement membrane zone of the lesional skin. The patient responded well to the combined use of corticosteroid and dapsone. Immunoelectron microscopy showed IgG and C3 deposition at the undersurface membrane of the basal cells and the lamina lucida. Electron microscopy of the nonvesiculated early erythematous skin showed small vacuoles and lacunae along the uppermost portion of the dermis. Although the clinical features of this patient and the good therapeutic response to dapsone were atypical, the results of immunopathology and immunoelectron microscopy were consistent with typical pemphigoid.